Myogenic stem cell-laden hydrogel scaffold in wound healing of the disrupted external anal sphincter

Montoya, T. Ignacio; Acevedo, Jesús F.; Smith, Benjamin; Keller, Patrick W.; Sailors, Joseph L.; Tang, Liping; Word, R. Ann; Wai, Clifford Y.

doi:10.1007/s00192-014-2620-6

Cited by 22 publications

(25 citation statements)

References 26 publications

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“…Previous studies attempted to treat FI using different regenerative medicine approaches. In another study, myogenic stem cells improved external sphincter function after transection of both the internal and external sphincter only when injected along with a biogel scaffold 2 weeks after sphincter damage . Other studies conducted in dog models of FI with internal and external sphincter injury have also injected myoblasts incorporated in polycaprolactone beads .…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Passive Fecal Incontinence in an Animal Model Using Engineered Biosphincters: A 3-Month Follow-Up Study

Bohl

Zakhem

Bitar

2017

Stem Cells Translational Medicine

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Fecal incontinence (FI) is the involuntary passage of fecal material. Current treatments have limited successful outcomes. The objective of this study was to develop a large animal model of passive FI and to demonstrate sustained restoration of fecal continence using anorectal manometry in this model after implantation of engineered autologous internal anal sphincter (IAS) biosphincters. Twenty female rabbits were used in this study. The animals were divided into three groups: (a) Non‐treated group: Rabbits underwent IAS injury by hemi‐sphincterectomy without treatment. (b) Treated group: Rabbits underwent IAS injury by hemi‐sphincterectomy followed by implantation of autologous biosphincters. (c) Sham group: Rabbits underwent IAS injury by hemi‐sphincterectomy followed by re‐accessing the surgical site followed by immediate closure without implantation of biosphincters. Anorectal manometry was used to measure resting anal pressure and recto‐anal inhibitory reflex (RAIR) at baseline, 1 month post‐sphincterectomy, up to 3 months after implantation and post‐sham. Following sphincterectomy, all rabbits had decreased basal tone and loss of RAIR, indicative of FI. Anal hygiene was also lost in the rabbits. Decreases in basal tone and RAIR were sustained more than 3 months in the non‐treated group. Autologous biosphincters were successfully implanted into eight donor rabbits in the treated group. Basal tone and RAIR were restored at 3 months following biosphincter implantation and were significantly higher compared with rabbits in the non‐treated and sham groups. Histologically, smooth muscle reconstruction and continuity was restored in the treated group compared with the non‐treated group. Results in this study provided promising outcomes for treatment of FI. Results demonstrated the feasibility of developing and validating a large animal model of passive FI. This study also showed the efficacy of the engineered biosphincters to restore fecal continence as demonstrated by manometry. Stem Cells Translational Medicine 2017;6:1795–1802

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Section: Discussionmentioning

confidence: 99%

Successful Treatment of Passive Fecal Incontinence in an Animal Model Using Engineered Biosphincters: A 3-Month Follow-Up Study

Bohl

Zakhem

Bitar

2017

Stem Cells Translational Medicine

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“…Tissue regeneration has been an important field of investigation in recent years and there has been considerable progress in treatments and techniques for various tissues, such as bone (Vimalraj & Selvamurugan 2014), muscle (Montoya et al 2015) and neuronal tissue (Feng et al 2014). However, only limited data are available for pulpal tissue.…”

Section: Introductionmentioning

confidence: 99%

Transdentinal photobiostimulation of stem cells from human exfoliated primary teeth

et al. 2016

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“…Going further, Lane et al[ 49 ] performed a more aggressive injury defined as a “proctoepisiotomy”, but did not describe the technical details or extension. Similar or minor modified procedures have been employed by Mazzanti[ 60 ], Salcedo[ 75 ], Elmi[ 50 ], Pathi[ 42 ], Fitzwater[ 54 ], Montoya[ 57 ], Kuismanen[ 65 ] and Li[ 67 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the same year, Montoya et al[ 57 ] published a bioengineering investigation with Sprague-Dawley female rats. Eighty rats underwent midline transection of both AS by a 7 mm full-thickness incision without repair.…”

Section: Animal Studies Publishedmentioning

confidence: 99%

Stem cell therapy for faecal incontinence: Current state and future perspectives

Trébol¹,

Carabias-Orgaz²,

García-Arranz³

et al. 2018

WJSC

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Faecal continence is a complex function involving different organs and systems. Faecal incontinence is a common disorder with different pathogeneses, disabling consequences and high repercussions for quality of life. Current management modalities are not ideal, and the development of new treatments is needed. Since 2008, stem cell therapies have been validated, 36 publications have appeared (29 in preclinical models and seven in clinical settings), and six registered clinical trials are currently ongoing. Some publications have combined stem cells with bioengineering technologies. The aim of this review is to identify and summarise the existing published knowledge of stem cell utilization as a treatment for faecal incontinence. A narrative or descriptive review is presented. Preclinical studies have demonstrated that cellular therapy, mainly in the form of local injections of muscle-derived (muscle derived stem cells or myoblasts derived from them) or mesenchymal (bone-marrow- or adipose-derived) stem cells, is safe. Cellular therapy has also been shown to stimulate the repair of both acute and subacute anal sphincter injuries, and some encouraging functional results have been obtained. Stem cells combined with normal cells on bioengineered scaffolds have achieved the successful creation and implantation of intrinsically-innervated anal sphincter constructs. The clinical evidence, based on adipose-derived stem cells and myoblasts, is extremely limited yet has yielded some promising results, and appears to be safe. Further investigation in both animal models and clinical settings is necessary to drawing conclusions. Nevertheless, if the preliminary results are confirmed, stem cell therapy for faecal incontinence may well become a clinical reality in the near future.

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Myogenic stem cell-laden hydrogel scaffold in wound healing of the disrupted external anal sphincter

Cited by 22 publications

References 26 publications

Successful Treatment of Passive Fecal Incontinence in an Animal Model Using Engineered Biosphincters: A 3-Month Follow-Up Study

Successful Treatment of Passive Fecal Incontinence in an Animal Model Using Engineered Biosphincters: A 3-Month Follow-Up Study

Transdentinal photobiostimulation of stem cells from human exfoliated primary teeth

Stem cell therapy for faecal incontinence: Current state and future perspectives

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